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Oxycodone for cancer-related pain
Mia Schmidt-Hansen1, Michael I Bennett, Stephanie Arnold
1National Collaborating Centre for Cancer, 2nd Floor, Park House, Greyfriars Road, Cardiff, UK, CF10 3AF. Mia.Schmidt-Hansen@wales.nhs.uk.
The Cochrane Database of Systematic Reviews
|February 28, 2015
Summary
Oxycodone provides similar pain relief and adverse events compared to other strong opioids like morphine for cancer pain. Given the low-quality evidence, further head-to-head studies are unlikely to be justified.
Area of Science:
- Oncology
- Pain Management
- Pharmacology
Background:
- Cancer pain often requires strong opioids such as oxycodone and morphine.
- These opioids may not be effective or well-tolerated by all patients.
- Assessing oxycodone's efficacy and tolerability against other analgesics is crucial.
Purpose of the Study:
- To evaluate the effectiveness and tolerability of oxycodone for managing cancer pain in adults.
- To compare oxycodone with placebo and other analgesic options.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) comparing oxycodone with placebo or active drugs.
- Searched multiple databases (e.g., Cochrane CENTRAL, MEDLINE, EMBASE) up to March 2014.
- Assessed study quality using Cochrane methodology and GRADE approach.
Main Results:
- 17 RCTs involving 1390 patients were included.
- Oxycodone showed similar pain relief and adverse events compared to immediate-release oxycodone and controlled-release morphine.
- No clear superiority of oxycodone was found over other opioids; evidence quality was low due to bias and small sample sizes.
Conclusions:
- Oxycodone offers comparable pain relief and adverse event profiles to morphine for cancer pain.
- The low reliability of current evidence suggests further large-scale head-to-head trials are not warranted.
- Oxycodone and morphine can be considered interchangeable first-line oral opioids for cancer pain management.